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Diagnostics
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Diagnosis, Treatment, and Management of COPD and Asthma
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Diagnosis, Treatment, and Management of COPD and Asthma

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 56480

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Dr. Koichi Nishimura

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Guest Editor
Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
Interests: COPD; asthma; interstitial pneumonia; patient-reported outocomes; quality of life; respiratory medicine; computed tomography

Special Issue Information

Dear Colleagues,

Chronic obstructive pulmonary disease (COPD) is a disorder characterised by airflow limitation and is one of the major causes of mortality and morbidity across the globe.  Although several guidelines have been published over the past three decades, they were generated in response to the fact that COPD is a major cause of mortality and morbidity and remains an important social problem. In the 20th century, forced expiratory volume in one second (FEV1) had been the single most important measure in patients with COPD from discriminative, evaluative, and predictive standpoints. We found that dyspnoea is a better mortality predictor than FEV1 in 2002 and exercise capacity in 2003. Subsequently, it has become apparent that physical activity is more predictive of mortality. Furthermore, we have recently developed the tendency to use reduction of the future risk of exacerbation as endpoint of relatively large-scaled clinical trials rather than the improvement of FEV1. Many researchers have continued to seek better outcome markers, and have also discussed what should be used as primary or secondary endpoints in clinical trials in subjects with COPD. We have undoubtedly made great progress but still have a lot of work to do for the best interests of patients.

It is our great pleasure to invite you to submit articles on the topic of chronic airway diseases, including COPD and asthma. This Special Issue, entitled “Diagnosis, Treatment, and Management of COPD and Asthma” will cover all aspects of clinical investigations regarding COPD and asthma. I believe this would be the best opportunity to publish your excellent work. Articles such as original articles or reviews are welcome. Please note that we do not accept case/brief reports.  Topics include but are not limited to:

  • Early COPD or late COPD
  • Blood eosinophil count as biomarker
  • Asthma and COPD overlap
  • Single-inhaler or multiple-inhaler triple therapy
  • Frequent exacerbators
  • Patient-reported outcomes
  • Health status or health-related quality of life
  • Dyspnoea measurement
  • Integrated care as well as COPD care bundles
  • Telemedicine and eHealth

Dr. Koichi Nishimura
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (18 papers)

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12 pages, 906 KiB  
Article
Diagnostic Value of the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in Various Respiratory Diseases: A Retrospective Analysis
by Milena-Adina Man, Lavinia Davidescu, Nicoleta-Stefania Motoc, Ruxandra-Mioara Rajnoveanu, Cosmina-Ioana Bondor, Carmen-Monica Pop and Claudia Toma
Diagnostics 2022, 12(1), 81; https://doi.org/10.3390/diagnostics12010081 - 30 Dec 2021
Cited by 11 | Viewed by 2314
Abstract
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio are two extensively used inflammatory markers that have been proved very useful in evaluating inflammation in several diseases. The present article aimed to investigate if they have any value in distinguishing among various respiratory disorders. [...] Read more.
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio are two extensively used inflammatory markers that have been proved very useful in evaluating inflammation in several diseases. The present article aimed to investigate if they have any value in distinguishing among various respiratory disorders. One hundred and forty-five patients with coronavirus disease 2019 (COVID-19), 219 patients with different chronic respiratory diseases (interstitial lung disease, obstructive sleep apnea(OSA)-chronic obstructive pulmonary disease (COPD) overlap syndrome, bronchiectasis) and 161 healthy individuals as a control group were included in the study. While neither NLR nor PLR had any power in differentiating between various diseases, PLR was found to be significant but poor as a diagnostic test when the control group was compared with the OSA-COPD group. NLR was found to be significant but poor as a diagnostic test when we compared the control group with all three groups (separately): the OSA-COPD group; interstitial lung disease group, and bronchiectasis group. NLR and PLR had poor power to discriminate between various respiratory diseases and cannot be used in making the differential diagnosis. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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29 pages, 1289 KiB  
Review
Neutrophils and Asthma
by Akira Yamasaki, Ryota Okazaki and Tomoya Harada
Diagnostics 2022, 12(5), 1175; https://doi.org/10.3390/diagnostics12051175 - 8 May 2022
Cited by 17 | Viewed by 5588
Abstract
Although eosinophilic inflammation is characteristic of asthma pathogenesis, neutrophilic inflammation is also marked, and eosinophils and neutrophils can coexist in some cases. Based on the proportion of sputum cell differentiation, asthma is classified into eosinophilic asthma, neutrophilic asthma, neutrophilic and eosinophilic asthma, and [...] Read more.
Although eosinophilic inflammation is characteristic of asthma pathogenesis, neutrophilic inflammation is also marked, and eosinophils and neutrophils can coexist in some cases. Based on the proportion of sputum cell differentiation, asthma is classified into eosinophilic asthma, neutrophilic asthma, neutrophilic and eosinophilic asthma, and paucigranulocytic asthma. Classification by bronchoalveolar lavage is also performed. Eosinophilic asthma accounts for most severe asthma cases, but neutrophilic asthma or a mixture of the two types can also present a severe phenotype. Biomarkers for the diagnosis of neutrophilic asthma include sputum neutrophils, blood neutrophils, chitinase-3-like protein, and hydrogen sulfide in sputum and serum. Thymic stromal lymphoprotein (TSLP)/T-helper 17 pathways, bacterial colonization/microbiome, neutrophil extracellular traps, and activation of nucleotide-binding oligomerization domain-like receptor family, pyrin domain-containing 3 pathways are involved in the pathophysiology of neutrophilic asthma and coexistence of obesity, gastroesophageal reflux disease, and habitual cigarette smoking have been associated with its pathogenesis. Thus, targeting neutrophilic asthma is important. Smoking cessation, neutrophil-targeting treatments, and biologics have been tested as treatments for severe asthma, but most clinical studies have not focused on neutrophilic asthma. Phosphodiesterase inhibitors, anti-TSLP antibodies, azithromycin, and anti-cholinergic agents are promising drugs for neutrophilic asthma. However, clinical research targeting neutrophilic inflammation is required to elucidate the optimal treatment. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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24 pages, 605 KiB  
Review
The Role of Digital Tools in the Timely Diagnosis and Prevention of Acute Exacerbations of COPD: A Comprehensive Review of the Literature
by Athanasios Konstantinidis, Christos Kyriakopoulos, Georgios Ntritsos, Nikolaos Giannakeas, Konstantinos I. Gourgoulianis, Konstantinos Kostikas and Athena Gogali
Diagnostics 2022, 12(2), 269; https://doi.org/10.3390/diagnostics12020269 - 21 Jan 2022
Cited by 5 | Viewed by 3344
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways and lung parenchyma with multiple systemic manifestations. Exacerbations of COPD are important events during the course of the disease, as they are associated with increased mortality, severe impairment of health-related [...] Read more.
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways and lung parenchyma with multiple systemic manifestations. Exacerbations of COPD are important events during the course of the disease, as they are associated with increased mortality, severe impairment of health-related quality of life, accelerated decline in lung function, significant reduction in physical activity, and substantial economic burden. Telemedicine is the use of communication technologies to transmit medical data over short or long distances and to deliver healthcare services. The need to limit in-person appointments during the COVID-19 pandemic has caused a rapid increase in telemedicine services. In the present review of the literature covering published randomized controlled trials reporting results regarding the use of digital tools in acute exacerbations of COPD, we attempt to clarify the effectiveness of telemedicine for identifying, preventing, and reducing COPD exacerbations and improving other clinically relevant outcomes, while describing in detail the specific telemedicine interventions used. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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2 pages, 163 KiB  
Editorial
Special Issue “Diagnosis, Treatment, and Management of COPD and Asthma”
by Koichi Nishimura
Diagnostics 2023, 13(16), 2634; https://doi.org/10.3390/diagnostics13162634 - 9 Aug 2023
Viewed by 595
Abstract
It has been my great pleasure to publish 17 papers in the Special Issue “Diagnosis, Treatment, and Management of COPD and Asthma” [...] Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
12 pages, 385 KiB  
Article
Are Fatigue and Pain Overlooked in Subjects with Stable Chronic Obstructive Pulmonary Disease?
by Koichi Nishimura, Kazuhito Nakayasu, Mio Mori, Ryo Sanda, Ayumi Shibayama and Masaaki Kusunose
Diagnostics 2021, 11(11), 2029; https://doi.org/10.3390/diagnostics11112029 - 2 Nov 2021
Cited by 4 | Viewed by 1585
Abstract
Although there have been many published reports on fatigue and pain in patients with chronic obstructive pulmonary disease (COPD), it is considered that these symptoms are seldom, if ever, asked about during consultations in Japanese clinical practice. To bridge this gap between the [...] Read more.
Although there have been many published reports on fatigue and pain in patients with chronic obstructive pulmonary disease (COPD), it is considered that these symptoms are seldom, if ever, asked about during consultations in Japanese clinical practice. To bridge this gap between the literature and daily clinical experience, the authors attempted to gain a better understanding of fatigue and pain in Japanese subjects with COPD. The Brief Fatigue Inventory (BFI) to analyse and quantify the degree of fatigue, the revised Short–Form McGill Pain Questionnaire 2 (SF-MPQ-2) for measuring pain and the Kihon Checklist to judge whether a participant is frail and elderly were administered to 89 subjects with stable COPD. The median BFI and SF-MPQ-2 Total scores were 1.00 [IQR: 0.11–2.78] and 0.00 [IQR: 0.00–0.27], respectively. They were all skewed toward the milder end of the respective scales. A floor effect was noted in around a quarter on the BFI and over half on the SF-MPQ-2. The BFI scores were significantly different between groups regarding frailty determined by the Kihon Checklist but not between groups classified by the severity of airflow limitation. Compared to the literature, neither fatigue nor pain are considered to be frequent, important problems in a real-world Japanese clinical setting, especially among subjects with mild to moderate COPD. In addition, our results might suggest that fatigue is more closely related to frailty than COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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16 pages, 350 KiB  
Review
Treatment Response Biomarkers in Asthma and COPD
by Howraman Meteran, Pradeesh Sivapalan and Jens-Ulrik Stæhr Jensen
Diagnostics 2021, 11(9), 1668; https://doi.org/10.3390/diagnostics11091668 - 13 Sep 2021
Cited by 5 | Viewed by 3486
Abstract
Chronic obstructive pulmonary disease (COPD) and asthma are two of the most common chronic diseases worldwide. Both diseases are heterogenous and complex, and despite their similarities, they differ in terms of pathophysiological and immunological mechanisms. Mounting evidence supports the presence of several phenotypes [...] Read more.
Chronic obstructive pulmonary disease (COPD) and asthma are two of the most common chronic diseases worldwide. Both diseases are heterogenous and complex, and despite their similarities, they differ in terms of pathophysiological and immunological mechanisms. Mounting evidence supports the presence of several phenotypes with various responses to treatment. A systematic and thorough assessment concerning the diagnosis of both asthma and COPD is crucial to the clinical management of the disease. The identification of different biomarkers can facilitate targeted treatment and monitoring. Thanks to the presence of numerous immunological studies, our understanding of asthma phenotypes and mechanisms of disease has increased markedly in the last decade, and several treatments with monoclonal antibodies are available. There are compelling data that link eosinophilia with an increased risk of COPD exacerbations but a greater treatment response and lower all-cause mortality. Eosinophilia can be considered as a treatable trait, and the initiation of inhaled corticosteroid in COPD patients with eosinophilia is supported in many studies. In spite of advances in our understanding of both asthma and COPD in terms pathophysiology, disease mechanisms, biomarkers, and response to treatment, many uncertainties in the management of obstructive airways exist. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
20 pages, 1076 KiB  
Review
ACO (Asthma–COPD Overlap) Is Independent from COPD: The Case Against
by Peter M. A. Calverley and Paul Phillip Walker
Diagnostics 2021, 11(7), 1189; https://doi.org/10.3390/diagnostics11071189 - 30 Jun 2021
Cited by 3 | Viewed by 2493
Abstract
Over the last decade interest has been shown in people with symptomatic lung disease who have features both of COPD and asthma. In this review we examine how COPD and asthma are defined and examine clinical characteristics of people defined by researchers as [...] Read more.
Over the last decade interest has been shown in people with symptomatic lung disease who have features both of COPD and asthma. In this review we examine how COPD and asthma are defined and examine clinical characteristics of people defined by researchers as having asthma-COPD overlap (ACO). We look at pathological and physiological features along with symptoms and consider the impact of each diagnosis upon therapeutic management. We highlight challenges in the diagnosis and management of airway disease and the various phenotypes that could be part of ACO, in so doing suggesting ways for the clinician to manage patients with features of both asthma and COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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18 pages, 2338 KiB  
Review
ACO (Asthma–COPD Overlap) Is Independent from COPD, a Case in Favor: A Systematic Review
by Naoya Fujino and Hisatoshi Sugiura
Diagnostics 2021, 11(5), 859; https://doi.org/10.3390/diagnostics11050859 - 11 May 2021
Cited by 11 | Viewed by 3529
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are now recognized to be able to co-exist as asthma–COPD overlap (ACO). It is clinically relevant to evaluate whether patients with COPD concurrently have components of asthma in primary care. This is because: (i) ACO is [...] Read more.
Asthma and chronic obstructive pulmonary disease (COPD) are now recognized to be able to co-exist as asthma–COPD overlap (ACO). It is clinically relevant to evaluate whether patients with COPD concurrently have components of asthma in primary care. This is because: (i) ACO is a relatively common condition among asthma (over 40 years of age) or COPD irrespective of its diagnosis criteria; (ii) patients with ACO can have higher frequency of exacerbation and more rapid decline in lung function than those with asthma or COPD; and (iii) asthmatic features such as eosinophilic airway inflammation are promising indicators for prediction of inhaled corticosteroid-responsiveness in COPD. The aim of this review to evaluate diagnostic markers for ACO. We searched PubMed for articles related to ACO published until 2020. Articles associated with diagnostic biomarkers were included. We identified a total of 25 studies, some of which have revealed that a combination of biomarkers such as fractional exhaled nitric oxide and serum immunoglobulin E is useful to discern type 2 inflammation in the airways of COPD. Here, we review the current understanding of the clinical characteristics, biomarkers and molecular pathophysiology of ACO in the context of how ACO can be differentiated from COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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9 pages, 415 KiB  
Review
The Importance of Appropriate Diagnosis in the Practical Management of Chronic Obstructive Pulmonary Disease
by Naozumi Hashimoto, Keiko Wakahara and Koji Sakamoto
Diagnostics 2021, 11(4), 618; https://doi.org/10.3390/diagnostics11040618 - 30 Mar 2021
Cited by 8 | Viewed by 2694
Abstract
Chronic obstructive pulmonary disease (COPD) is projected to continue to contribute to an increase in the overall worldwide burden of disease until 2030. Therefore, an accurate assessment of the risk of airway obstruction in patients with COPD has become vitally important. Although the [...] Read more.
Chronic obstructive pulmonary disease (COPD) is projected to continue to contribute to an increase in the overall worldwide burden of disease until 2030. Therefore, an accurate assessment of the risk of airway obstruction in patients with COPD has become vitally important. Although the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the American Thoracic Society (ATS) and European Respiratory Society (ERS), and the Japanese Respiratory Society (JRS) provide the criteria by which to diagnose COPD, many studies suggest that it is in fact underdiagnosed. Its prevalence increases, while the impact of COPD-related systemic comorbidities is also increasingly recognized in clinical aspects of COPD. Although a recent report suggests that spirometry should not be used to screen for airflow limitation in individuals without respiratory symptoms, the early detection of COPD in patients with no, or few, symptoms is an opportunity to provide appropriate management based on COPD guidelines. Clinical advances have been made in pharmacotherapeutic approaches to COPD. This article provides a current understanding of the importance of an appropriate diagnosis in the real-world management of COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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11 pages, 783 KiB  
Review
Motor Pathophysiology Related to Dyspnea in COPD Evaluated by Cardiopulmonary Exercise Testing
by Keisuke Miki
Diagnostics 2021, 11(2), 364; https://doi.org/10.3390/diagnostics11020364 - 21 Feb 2021
Cited by 4 | Viewed by 5231
Abstract
In chronic obstructive pulmonary disease (COPD), exertional dyspnea, which increases with the disease’s progression, reduces exercise tolerance and limits physical activity, leading to a worsening prognosis. It is necessary to understand the diverse mechanisms of dyspnea and take appropriate measures to reduce exertional [...] Read more.
In chronic obstructive pulmonary disease (COPD), exertional dyspnea, which increases with the disease’s progression, reduces exercise tolerance and limits physical activity, leading to a worsening prognosis. It is necessary to understand the diverse mechanisms of dyspnea and take appropriate measures to reduce exertional dyspnea, as COPD is a systemic disease with various comorbidities. A treatment focusing on the motor pathophysiology related to dyspnea may lead to improvements such as reducing dynamic lung hyperinflation, respiratory and metabolic acidosis, and eventually exertional dyspnea. However, without cardiopulmonary exercise testing (CPET), it may be difficult to understand the pathophysiological conditions during exercise. CPET facilitates understanding of the gas exchange and transport associated with respiration-circulation and even crosstalk with muscles, which is sometimes challenging, and provides information on COPD treatment strategies. For respiratory medicine department staff, CPET can play a significant role when treating patients with diseases that cause exertional dyspnea. This article outlines the advantages of using CPET to evaluate exertional dyspnea in patients with COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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15 pages, 1539 KiB  
Article
Participation of HHIP Gene Variants in COPD Susceptibility, Lung Function, and Serum and Sputum Protein Levels in Women Exposed to Biomass-Burning Smoke
by Alejandro Ortega-Martínez, Gloria Pérez-Rubio, Alejandra Ramírez-Venegas, María Elena Ramírez-Díaz, Filiberto Cruz-Vicente, María de Lourdes Martínez-Gómez, Espiridión Ramos-Martínez, Edgar Abarca-Rojano and Ramcés Falfán-Valencia
Diagnostics 2020, 10(10), 734; https://doi.org/10.3390/diagnostics10100734 - 23 Sep 2020
Cited by 6 | Viewed by 3477
Abstract
Background: A variety of organic materials (biomass) are burned for cooking and heating purposes in poorly ventilated houses; smoke from biomass combustion is considered an environmental risk factor for chronic obstructive pulmonary disease COPD. In this study, we attempted to determine the participation [...] Read more.
Background: A variety of organic materials (biomass) are burned for cooking and heating purposes in poorly ventilated houses; smoke from biomass combustion is considered an environmental risk factor for chronic obstructive pulmonary disease COPD. In this study, we attempted to determine the participation of single-nucleotide variants in the HHIP (hedgehog-interacting protein) gene in lung function, HHIP serum levels, and HHIP sputum supernatant levels in Mexican women with and without COPD who were exposed to biomass-burning smoke. Methods: In a case-control study (COPD-BS, n = 186, BBES, n = 557) in Mexican women, three SNPs (rs13147758, rs1828591, and rs13118928) in the HHIP gene were analyzed by qPCR; serum and supernatant sputum protein levels were determined through ELISA. Results: The rs13118928 GG genotype is associated with decreased risk (p = 0.021, OR = 0.51, CI95% = 0.27–0.97) and the recessive genetic model (p = 0.0023); the rs1828591-rs13118928 GG haplotype is also associated with decreased risk (p = 0.04, OR = 0.65, CI95% 0.43–0.98). By the dominant model (rs13118928), the subjects with one or two copies of the minor allele (G) exhibited higher protein levels. Additionally, two correlations with the AG genotype were identified: BBES with FEV1 (p = 0.03, r2 = 0.53) and COPD-BS with FEV1/FVC (p = 0.012, r2 = 0.54). Conclusions: Single-nucleotide variants in the HHIP gene are associated with decreased COPD risk, higher HHIP serum levels, and better lung function in Mexican women exposed to biomass burning. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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15 pages, 1267 KiB  
Article
Combination of Systemic Inflammatory Biomarkers in Assessment of Chronic Obstructive Pulmonary Disease: Diagnostic Performance and Identification of Networks and Clusters
by Iva Hlapčić, Daniela Belamarić, Martina Bosnar, Domagoj Kifer, Andrea Vukić Dugac and Lada Rumora
Diagnostics 2020, 10(12), 1029; https://doi.org/10.3390/diagnostics10121029 - 30 Nov 2020
Cited by 12 | Viewed by 2262
Abstract
Interleukin (IL)-1α, IL-1β, IL-6, IL-8 and tumor necrosis factor (TNF)α contribute to inflammation in chronic obstructive pulmonary disease (COPD). We wanted to investigate their interrelations and association with disease severity, as well as to combine them with other inflammation-associated biomarkers and evaluate their [...] Read more.
Interleukin (IL)-1α, IL-1β, IL-6, IL-8 and tumor necrosis factor (TNF)α contribute to inflammation in chronic obstructive pulmonary disease (COPD). We wanted to investigate their interrelations and association with disease severity, as well as to combine them with other inflammation-associated biomarkers and evaluate their predictive value and potential in identifying various patterns of systemic inflammation. One hundred and nine patients with stable COPD and 95 age- and sex-matched controls were enrolled in the study. Cytokines’ concentrations were determined in plasma samples by antibody-based multiplex immunosorbent assay kits. Investigated cytokines were increased in COPD patients but were not associated with disease or symptoms severity. IL-1β, IL-6 and TNFα showed the best discriminative values regarding ongoing inflammation in COPD. Inflammatory patterns were observed in COPD patients when cytokines, C-reactive protein (CRP), fibrinogen (Fbg), extracellular adenosine triphosphate (eATP), extracellular heat shock protein 70 (eHsp70) and clinical data were included in cluster analysis. IL-1β, eATP and eHsp70 combined correctly classified 91% of cases. Therefore, due to the heterogeneity of COPD, its assessment could be improved by combination of biomarkers. Models including IL-1β, eATP and eHsp70 might identify COPD patients, while IL-1β, IL-6 and TNFα combined with CRP, Fbg, eATP and eHsp70 might be informative regarding various COPD clinical subgroups. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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18 pages, 2239 KiB  
Article
Salivary Metabolic Profile of Patients with Lung Cancer, Chronic Obstructive Pulmonary Disease of Varying Severity and Their Comorbidity: A Preliminary Study
by Lyudmila V. Bel’skaya, Elena A. Sarf, Denis V. Solomatin and Victor K. Kosenok
Diagnostics 2020, 10(12), 1095; https://doi.org/10.3390/diagnostics10121095 - 15 Dec 2020
Cited by 2 | Viewed by 1951
Abstract
The aim of the work was to study the features of the salivary biochemical composition in the combined pathology of lung cancer and chronic obstructive pulmonary disease (COPD) of varying severity (COPD I, COPD II). The study group included patients with lung cancer [...] Read more.
The aim of the work was to study the features of the salivary biochemical composition in the combined pathology of lung cancer and chronic obstructive pulmonary disease (COPD) of varying severity (COPD I, COPD II). The study group included patients with lung cancer (n = 392), non-malignant lung pathologies (n = 168) and healthy volunteers (n = 500). Before treatment, the salivary biochemical composition was determined according to 34 indicators. Survival analysis performed by the Kaplan-Meier method. Biochemical parameters (catalase, imidazole compounds ICs, sialic acids, lactate dehydrogenase (LDH)) that can be used to monitor patients at risk (COPD I) for timely diagnosis of lung cancer are determined. A complex of salivary biochemical indicators with prognostic value in lung cancer was revealed. For patients with lung cancer without COPD, a group of patients with a favorable prognosis can be distinguished with a combination of ICs < 0.478 mmol/L and LDH >1248 U/L (HR = 1.56, 95% CI 0.40–6.07, p = 0.03891). For COPD I, a level of ICs < 0.182 mmol/L are prognostically favorable (HR = 1.74, 95% CI 0.71–4.21, p = 0.07270). For COPD II, combinations of pH < 6.74 and LDH >1006 U/L are prognostically favorable. In general, for patients with lung cancer in combination with COPD I, the prognosis is more favorable than without COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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11 pages, 1000 KiB  
Article
Is the 1-Minute Sit-To-Stand Test a Good Tool to Evaluate Exertional Oxygen Desaturation in Chronic Obstructive Pulmonary Disease?
by Ana L. Fernandes, Inês Neves, Graciete Luís, Zita Camilo, Bruno Cabrita, Sara Dias, Jorge Ferreira and Paula Simão
Diagnostics 2021, 11(2), 159; https://doi.org/10.3390/diagnostics11020159 - 22 Jan 2021
Cited by 5 | Viewed by 2978
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with exertional oxygen desaturation, which may be evaluated using the 6-minute walking test (6MWT). However, it is a time-consuming test. The 1-minute sit-to-stand test (1STST) is a simpler test, already used to evaluate the [...] Read more.
Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with exertional oxygen desaturation, which may be evaluated using the 6-minute walking test (6MWT). However, it is a time-consuming test. The 1-minute sit-to-stand test (1STST) is a simpler test, already used to evaluate the functional status. The aim of this study was to compare the 1STST to the 6MWT in the evaluation of exertional desaturation. Methods: This was a cross-sectional study including 30 stable COPD patients who performed the 6MWT and 1STST on the same day. Six-minute walking distance (6MWD), number of 1STST repetitions (1STSTr), and cardiorespiratory parameters were recorded. Results: A significant correlation was found between the 6MWD and the number of 1STSTr (r = 0.54; p = 0.002). The minimum oxygen saturation (SpO2) in both tests showed a good agreement (intraclass correlation coefficient (ICC) 0.81) and correlated strongly (r = 0.84; p < 0.001). Regarding oxygen desaturation, the total agreement between the tests was 73.3% with a fair Cohen’s kappa (κ = 0.38; p = 0.018), and 93.33% of observations were within the limits of agreement for both tests in the Bland–Altman analysis. Conclusion: The 1STST seems to be a capable tool of detecting exercise-induced oxygen desaturation in COPD. Because it is a less time- and resources-consuming test, it may be applied during the outpatient clinic consultation to regularly evaluate the exercise capacity and exertional desaturation in COPD. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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12 pages, 958 KiB  
Article
Is Blood Eosinophil Count a Biomarker for Chronic Obstructive Pulmonary Disease in a Real-World Clinical Setting? Predictive Property and Longitudinal Stability in Japanese Patients
by Koichi Nishimura, Masaaki Kusunose, Ryo Sanda, Mio Mori, Ayumi Shibayama and Kazuhito Nakayasu
Diagnostics 2021, 11(3), 404; https://doi.org/10.3390/diagnostics11030404 - 27 Feb 2021
Cited by 4 | Viewed by 2066
Abstract
The authors examined predictive properties and the longitudinal stability of blood eosinophil count (BEC) or three strata (<100 cells/mm3, 100–299 cells/mm3 and ≥300 cells/mm3) in patients with chronic obstructive pulmonary disease (COPD) for up to six and a [...] Read more.
The authors examined predictive properties and the longitudinal stability of blood eosinophil count (BEC) or three strata (<100 cells/mm3, 100–299 cells/mm3 and ≥300 cells/mm3) in patients with chronic obstructive pulmonary disease (COPD) for up to six and a half years as part of a hospital-based cohort study. Of the 135 patients enrolled, 21 (15.6%) were confirmed to have died during the follow-up period. Episodes of acute exacerbation of COPD (AECOPD) were identified in 74 out of 130 available patients (56.9%), and admission due to AECOPD in 35 out of 132 (26.5%). Univariate Cox proportional hazards analyses revealed that almost all the age, forced expiratory volume in 1 s (FEV1) and health status measures using St. George’s Respiratory Questionnaire (SGRQ) Total and COPD Assessment Test (CAT) Score were significantly related to these types of events, but the relationship between age and AECOPD did not reach statistical significance (p = 0.05). Neither BEC nor the three different groups stratified by BEC were significant predictors of any subsequent events. There were no significant differences in the BEC between Visits 1–3 (p = 0.127, Friedman test). The ICC value was 0.755 using log-transformed data, indicating excellent repeatability. In the case of assigning to strata, Fleiss’ kappa was calculated to be 0.464, indicating moderate agreement. The predictive properties of BEC may be limited in a real-world Japanese clinical setting. Attention must be paid to the fact that the longitudinal stability of the three strata is regarded as moderate. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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15 pages, 2427 KiB  
Article
Characterization of the COPD Salivary Fingerprint through Surface Enhanced Raman Spectroscopy: A Pilot Study
by Cristiano Carlomagno, Alice Gualerzi, Silvia Picciolini, Francesca Rodà, Paolo Innocente Banfi, Agata Lax and Marzia Bedoni
Diagnostics 2021, 11(3), 508; https://doi.org/10.3390/diagnostics11030508 - 12 Mar 2021
Cited by 2 | Viewed by 2032
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a debilitating pathology characterized by reduced lung function, breathlessness and rapid and unrelenting decrease in quality of life. The severity rate and the therapy selection are strictly dependent on various parameters verifiable after years of clinical observations, [...] Read more.
Chronic Obstructive Pulmonary Disease (COPD) is a debilitating pathology characterized by reduced lung function, breathlessness and rapid and unrelenting decrease in quality of life. The severity rate and the therapy selection are strictly dependent on various parameters verifiable after years of clinical observations, missing a direct biomarker associated with COPD. In this work, we report the methodological application of Surface Enhanced Raman Spectroscopy combined with Multivariate statistics for the analysis of saliva samples collected from 15 patients affected by COPD and 15 related healthy subjects in a pilot study. The comparative Raman analysis allowed to determine a specific signature of the pathological saliva, highlighting differences in determined biological species, already studied and characterized in COPD onset, compared to the Raman signature of healthy samples. The unsupervised principal component analysis and hierarchical clustering revealed a sharp data dispersion between the two experimental groups. Using the linear discriminant analysis, we created a classification model able to discriminate the collected signals with accuracies, specificities, and sensitivities of more than 98%. The results of this preliminary study are promising for further applications of Raman spectroscopy in the COPD clinical field. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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15 pages, 1630 KiB  
Article
Novel App-Based Portable Spirometer for the Early Detection of COPD
by Ching-Hsiung Lin, Shih-Lung Cheng, Hao-Chien Wang, Wu-Huei Hsu, Kang-Yun Lee, Diahn-Warng Perng, Hen-I. Lin, Ming-Shian Lin, Jong-Rung Tsai, Chin-Chou Wang, Sheng-Hao Lin, Cheng-Yi Wang, Chiung-Zuei Chen, Tsung-Ming Yang, Ching-Lung Liu, Tsai-Yu Wang and Meng-Chih Lin
Diagnostics 2021, 11(5), 785; https://doi.org/10.3390/diagnostics11050785 - 27 Apr 2021
Cited by 9 | Viewed by 3345
Abstract
Chronic obstructive pulmonary disease (COPD) is preventable and treatable. However, many patients remain undiagnosed and untreated due to the underutilization or unavailability of spirometers. Accordingly, we used Spirobank Smart, an app-based spirometer, for facilitating the early detection of COPD in outpatient clinics. This [...] Read more.
Chronic obstructive pulmonary disease (COPD) is preventable and treatable. However, many patients remain undiagnosed and untreated due to the underutilization or unavailability of spirometers. Accordingly, we used Spirobank Smart, an app-based spirometer, for facilitating the early detection of COPD in outpatient clinics. This prospective study recruited individuals who were at risk of COPD (i.e., with age of ≥40 years, ≥10 pack-years of smoking, and at least one respiratory symptoms) but had no previous COPD diagnosis. Eligible participants were examined with Spirobank Smart and then underwent confirmatory spirometry (performed using a diagnostic spirometer), regardless of their Spirobank Smart test results. COPD was defined and confirmed using the postbronchodilator forced expiratory volume in 1 s/forced vital capacity values of <0.70 as measured by confirmatory spirometry. A total of 767 participants were enrolled and examined using Spirobank Smart; 370 participants (94.3% men, mean age of 60.9 years and mean 42.6 pack-years of smoking) underwent confirmatory spirometry. Confirmatory spirometry identified COPD in 103 participants (27.8%). At the optimal cutoff point of 0.74 that was determined using Spirobank Smart for COPD diagnosis, the area under the receiver operating characteristic was 0.903 (95% confidence interval (CI) = 0.860–0.947). Multivariate logistic regression revealed that participants who have an FEV1/FVC ratio of <74% that was determined using Spirobank Smart (odds ratio (OR) = 58.58, 95% CI = 27.29–125.75) and old age (OR = 3.23, 95% CI = 1.04–10.07 for 60 ≤ age < 65; OR = 5.82, 95% CI = 2.22–15.27 for age ≥ 65) had a higher risk of COPD. The Spirobank Smart is a simple and adequate tool for early COPD detection in outpatient clinics. Early diagnosis and appropriate therapy based on GOLD guidelines can positively influence respiratory symptoms and quality of life. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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11 pages, 1442 KiB  
Article
COPD Guidelines in the Asia-Pacific Regions: Similarities and Differences
by Shih-Lung Cheng and Ching-Hsiung Lin
Diagnostics 2021, 11(7), 1153; https://doi.org/10.3390/diagnostics11071153 - 24 Jun 2021
Cited by 12 | Viewed by 5560
Abstract
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is associated with significant morbidity and mortality, giving rise to an enormous social and economic burden. The Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) [...] Read more.
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is associated with significant morbidity and mortality, giving rise to an enormous social and economic burden. The Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) report is one of the most frequently used documents for managing COPD patients worldwide. A survey was conducted across country-level members of Asia-Pacific Society of Respiratory (APSR) for collecting an updated version of local COPD guidelines, which were implemented in each country. This is the first report to summarize the similarities and differences among the COPD guidelines across the Asia-Pacific region. The degree of airflow limitation, assessment of COPD severity, management, and pharmacologic therapy of stable COPD will be reviewed in this report. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Management of COPD and Asthma)
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